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[{"$nulls":4},"メダル・賞状の交付申請書"]
[]
[null,"大会の正式名称",{"$nulls":10},"競技会の\nグレード"]
[null,"開催年月日",null,"西暦２０",null,"年",null,"月",null,"日","～",null,"月",null,"日"]
[null,"送付先住所",null,"〒"]
[null,"送付先名称"]
[null,"TEL（送付先の）"]
[null,"申込責任者"]
[null,"申込者連絡先"]
[]
[null,null,"メダル",null,null,"賞状",{"$nulls":4},"選手権証"]
[null,null,"金",null,"ヶ","必要数",{"$nulls":3},"枚","必要数",{"$nulls":3},"枚"]
[null,null,"銀",null,"ヶ","予備",{"$nulls":3},"枚","予備",{"$nulls":3},"枚"]
[null,null,"銅",null,"ヶ","合計",null,{"$f":"H12+H13","v":0},null,"枚","合計",null,{"$f":"M12+M13","v":0},null,"枚"]
[]
[null,null,"種類",{"$nulls":8},"枚数",null,"文面"]
[null,null,"本部用賞状（日ラ会長名・公印入り）"]
[null,null,"地方用賞状（日ラ会長名＆公印・加盟団体会長名入り）"]
[null,null,"地方用賞状（加盟団体会長名入り）"]
[null,null,"賞状台紙のみ（日ラロゴのみ）※会長名・文面は入りません"]
[null,null,"その他　※別途ご指示下さい"]
[null,null,"備　考\n（別途指示欄）"]
[]
[null,null,"※　加盟団体会長名入りの賞状をご希望される場合は、会長名を下にご記入下さい。"]
[]
[null,null,"加盟団体会長名　"]
[]
[{"$nulls":6},"以上、申請致しますので送付を願います。"]